Thursday, 19 March 2020

Judicial Review withdrawn and other stories

The Good Thinking Society (GTS) have withdrawn their judicial review of the Professional Standards Authority's (PSA) decision to unconditionally accredit the Society of Homeopaths (SoH).

This is because the 2020 Accreditation with Conditions achieved much of what the GTS and others wanted. Before considering the GTS's statement, some context may help.

Timing
The PSA knew the date of the judicial review had been set for 18-19/03/2020 by 15/01/2020. As late as November 2019 the PSA were of the opinion that judicial review would not be completed before the 2020 Accreditation. The Accreditation with Conditions was announced on 13/02/2020. In previous years the Accreditation decisions were reported months after the notional January date.

If the judicial review had commenced before the Accreditation process was complete, things could have become very messy and uncertain. It's known that the PSA were expecting the Judicial Review process to be expensive.

The PSA had reasons enough to make sure that the Accreditation process completed in a timely manner. They may have impressed upon the SoH the need not to mess about as they have had a tendency to do in the past. The SoH certainly knew the date of the judicial review in December 2019. It's known that the SoH took legal advice themselves. Depending on what they asked, they may well have been aware of what kind of mess they could find themselves in.

Statement
The GTS state -
As many of our supporters will know, the Professional Standards Authority has imposed strict conditions on the Society of Homeopaths as part of their most recent annual accreditation of the homeopathic membership organisation as an Accredited Voluntary Register. 
Those conditions include forbidding registrants of the Society of Homeopaths from practising CEASE therapy – an ineffective autism ‘cure’ aimed at children which is based on anti-vaccination misinformation – and from making any claims regarding vaccination. 
We at the Good Thinking Society welcome these conditions, having spent the last few years raising concerns over the Society of Homeopaths’ unwillingness or inability to prevent their registrants from claiming to cure autism. In June 2019, we filed a Judicial Review challenging the PSA’s 2019 reaccreditation of the Society of Homeopaths, given that the PSA had acknowledged that CEASE therapy was potentially harmful and that it conflicted with NHS advice regarding vaccinations against potentially life-threatening conditions. In that 2019 reaccreditation, the PSA did not require, or even recommend, that the Society of Homeopaths prevent their members from offering CEASE therapy. 
We challenged the decision because the measures recommended by the PSA in 2019 did not come close to mitigating the potential harms associated with CEASE therapy, despite there being evidence that Society of Homeopaths registrants continued to practice CEASE therapy. We also argued that the PSA had failed to ask the Society of Homeopaths how many of its registrants practised CEASE therapy, and failed to verify information provided to them (some of which we had found to be inaccurate), before coming to their decision. Further, we felt that the PSA had not properly taken account of the potential equality implications of its decision, given that CEASE therapy is aimed at autistic people, and autistic children in particular.  
With that in mind, we were very pleased to see that strict conditions have now been placed upon the Society of Homeopaths, binding them to take action to prevent their registrants from making autism-‘cure’ claims or from spreading anti-vaccination misinformation. We are encouraged to see that the PSA have come to accept that nothing short of an outright ban on CEASE therapy is sufficient to protect the public, and that they also took into account the equality implications of accrediting the Society of Homeopaths whilst its members practice CEASE therapy. 
We are therefore happy to withdraw our legal challenge to the 2019 decision.
This is very clear but did not stop various homeopaths from thinking the withdrawal some kind of victory. Ex-SoH CEO Mark Taylor has a thing about the GTS and could not help himself in terms of getting hold of the wrong end of the stick -




No Mark, the GTS have not been thwarted and it is very likely that the Conditions imposed on the SoH are at least partly the result of the GTS's threatened legal action, As discussed here, the Conditions imposed on the SoH are stringent to say the least. If the SoH, members and their supporters have anything to celebrate it's that Accreditation wasn't removed.

The SoH will be hard pressed to meet the Conditions and there is the possibility of Accreditation being removed. 
However, while putting in place a ban on CEASE therapy is obviously a great step forward, any prohibition is meaningless unless it is adhered to, and disciplinary action is taken by the Society of Homeopaths against those registrants who ignore it. We will therefore be paying close attention over the coming year, to ensure that registrants of the Society of Homeopaths do not continue to offer CEASE therapy or act in breach of any of the other conditions imposed upon the Society by the PSA. If we do find registrants acting in breach, we will raise our concerns with the Society of Homeopaths, and the PSA as necessary – as we did prior to the 2019 reaccreditation. We trust that, this time, our concerns will be taken seriously, and that the need for further legal action can be avoided in the future.
The GTS have also called on supporters to report to them problem marketing claims on SoH member websites. Other parties are also monitoring claims. 

Question
The point is made that PSA Accredited the SoH unconditionally in 2019 despite the very obvious problems being pointed out to them. Something else that was also pointed out back then was the possibility of judicial review if the wrong decision was made. Reading the current Accreditation Report it is difficult not to come to the conclusions that the previous Accreditation was an error.

Whether or not the PSA would have Accredited with Conditions without the threat of judicial review, without the various media stories and the intervention of Sir Simon Stevens and Professor Stephen Powis is unknown but it certainly made it a lot more likely. Public bodies can be very sensitive to negative publicity. It is possible that without the GTS getting involved, the PSA would have accredited unconditionally even when presented with evidence of real problems.

What next?
Depending on when the clock started ticking (ie January or Febrary) by month 3 the SoH have must -
  • Agree wording of Position Statements with PSA and make them public. Specifically, that CEASE (and by extension the very similar Homeopathic Therapy) is prohibited. The same seems to apply to the use of nutritional supplements.
  • Agree wording of Position Statements with PSA and make them public that relate to the prohibition on the discussion of vaccination other than to direct to public to NHS and similiar reputable resources. This applies to any public/professional interaction. It does necessarily include talks, other public meetings, training/teaching and social media. Similarly, it would apply to listing on third party directory type sites. 
  • Agree wording of Position Statements with PSA and make them public that relate to the prohibition of unspecified "adjunctive therapies".
  • Produce first quarterly reportly on monitoring of member website compliance with stated Standards.
Every following quarter the SoH must submit further monitoring reports with the goal of 100% compliance in 12 months.

The SoH should be able to meet the 3 month requirements. It maybe a struggle for them to come up with wording that satisfies the PSA but not impossible. In theory, the SoH have already communicated the restrictions on practice to their members. Making public statements should not be a trigger for more members to resign. The SoH should also be able to produce a monitoring report. But if they don't?

Following up on timed Conditions 
8.2 If as part of accreditation the Accredited Register was issued Conditions with a deadline, it will be required to submit a report by the date specified outlining how it has met the Conditions. The register will be required to provide supporting evidence to demonstrate compliance. 
8.3 The team will review the actions taken and follow up with any clarifications if required. The team will then report to a Moderator (one of the Authority’s Director-level staff members) who will consider the evidence provided and decide if the Condition has been met. 
8.4 The Accredited Register will be informed in writing of the Panel’s decision and a summary will be included in the next annual review report. Once the Panel is satisfied that the Condition has been met, this will be removed from our directory. 
8.5 Conditions that have a deadline of the annual review will be assessed as part of the annual review and considered by the Moderator.
It isn't completely clear what happens if a register has not met Conditions. Can the Moderator make the decision to suspend or remove Accreditation or does that have to be made by an Accreditation Panel? Can such a decision be appealed?

Producing further quarterly reports should not be an issue. The Accreditation Report doesn't set specific progress targets except for the last one. It doesn't seem that suspension or removal of Accreditation can be triggered at the 6 and 9 month stages. 

It is unlikely that the SoH can achieve 100% voluntary compliance by the 12 month stage. It will have to expel non-compliant members in order to meet that target. It is assumed that the SoH will have to follow some sort of formal process (see their complaint process) but these take time and require resources. Summary expulsion might be a breach of the Standards. It will have to start sooner rather than later. Perhaps making an example of a few members might encourage voluntary compliance? Something else that the SoH needs to be away of is that once the formal process begins, the expectation is that resignation does not end the investigation. Of course, the threat of formal action might bring about resignation.

But...
A previous post described the Accreditation process in more detail but in short, the SoH will have to decide by September 2020 whether it will seek Accreditation for 2021. It will have until November 2020 to make formal application.

It might decide against especially if it is finding the cost of compliance too high. If it does decide not to pursue 2021 Accreditation, it might as well cut its loss and immediately leave the Accredited Registers Scheme.

UPDATE: 22/03/2020
It appears that Emily Buttrum is no longer CEO of the SoH. No announcement has been made. The only public indication is in a SoH news item on COVID-19 and a reference to an "Interim Chief Executive". It is possible that an announcement has been made to members. A rumour had been circulating prior to the news item.

There is no indication as why Buttrum has departed nor exactly when she departed. People can leave their positions suddenly for many different reasons that are not work related. Perhaps the SoH have been pre-occupied with other things. but the lack of any announcement is strange to say the least. It raises all sorts of questions. The SoH says very little publicly these days so there nothing to go on.

It should be noted that Buttrum's tenure coincided with a very difficult period for the SoH. Retaining Accreditation was doubtless very difficult and painful for them. As stated, it isn't clear when she left but the Accreditation was announced on 13th February. Typically, the SoH has a Board meeting in February. 

The interim CEO is Richard O'Quinn. O'Quinn seems to have a background in marketing. O'Quinn has been a Director of the SoH for nearly six years and his term will be up soon. O'Quinn is also a Trustee of the British Homeopathic Association (BHA). He has acted as interim CEO of the Faculty of Homeopathy (FoH) in the past.

The change of CEO is generally very disruptive for an organisation (unless it has decent succession planning). It is not known how important Buttrum was in retaining Accreditation but as discussed above, the SoH are not out of the woods yet. It remains to be seen if the SoH will meet the Conditions.

The SoH accounts for 2019 have now been filed with Companies House. It has posted a loss of around £36k - the third year in succession it has run at a deficit. Income is down but changes to the way that it reports income mean that it is not possible to determine the impact of declining membership numbers etc. The SoH does seem to be controlling costs better though.












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